Frequency of sensory motor neuropathy in type 2 diabetics

To determine the frequency of sensory motor neuropathy in type 2 diabetics at the time of presentation to the hospital. Non interventional, descriptive. The study was conducted at Medical Unit-1, Jinnah Postgraduate Medical Center, Karachi, from November 2005 to April 2006. Patients of different ages and either gender with history of confirmed diabetes for ten years and above, on regular follow up were included. Those with non-diabetic causes of hyperglycemia or neuropathy were excluded. Relevant features like age, gender, treatment, symptoms, signs, nerve conduction study [NCS] results, duration of Diabetes mellitus [DM], fasting blood sugar [FBS] and serum values of glycosylated hemoglobin [HB1Ac] were recorded. Out of a total of 300 patients, there were 111 female and 189 male patients. Mean age was 58 +/- 11.23 years. Mean duration of diabetes was 13.6 +/- 5.48 years. One hundred and twenty three patients had symptoms of neuropathy. Clinical examination revealed mixed sensory and motor signs in 135 [45%] patients. Nerve conduction studies revealed abnormalities in 159 [53%] patients. Among patients having an abnormal NCS, the fasting blood glucose [FBS] was <120 mg/dl in 12 [7.5%] patients, while it was > 120mg/dl in 147 [91%] patients. The glycosylated hemoglobin ranged from 4-15% with mean of 8.1% and standard deviation of 2.5%. This showed significant association [p <0.001] of peripheral neuropathy with abnormal FBS, HB1Ac and duration of diabetes. NCS diagnosed the neuropathy in more than half of the total number of patients, including both symptomatic and asymptomatic patients. Majority of the patients revealed symmetrical and a mixed type [motor and sensory] polyneuropathy. This shows that nerve conduction may not be concordant with the clinical signs and symptoms. NCS detects neuropathy much earlier, before it becomes evident clinically. The neuropathy is associated with abonromal fasting blood sugar, HB1AC and duration of diabetes

Deliberate self harm: frequency and associated factors

To determine the frequency of deliberate self harm and its associated factors. Descriptive study. The study was conducted at NPCC [National Poison Control Centre], medical unit I, Jinnah postgraduate medical centre Karachi, from 1st sept-31st December 2004. A Total of 150 patients of deliberate self harm by means of poisoning who were admitted in NPCC, were included in the study. Data was retrieved from the files on a structured Performa. The variables of study include gender, age, marital status, monthly income and number of dependents and history of prior attempts. Out of 150 patients, 86 patients [57%] were females and 64 [43%] males, mean age was 20 years + 5 years. 71 patients [47%] were unmarried and 72 [48%] married. 100 patients had monthly income of 6000 or less. 128 patients [85%] had more than 3 dependents. 5% of patients had a prior history of deliberate self harm. Deliberate self harm is more common in females particularly of younger age group. Various psychosocial factors are involved in motivation. To prevent repeated acts of deliberate self harm or suicidal attempts in cases of Para suicide, an individualized plan should be made to counsel high risk individuals and to educate them by addressing different aspects of precipitating factors, as well as a proper treatment of psychiatric problem